Abstract
A 58-year-old man was admitted to our hospital because of a subcutaneous abscess in the left sternoclavicular region. Two months before, he had undergone resection of a small intestinal puncture after a traffic accident and a left subclavian venous catheter was inserted. The patient underwent surgical exploration with removal of the necrotic bone under a diagnosis of left clavicular osteomyelitis. We compared this case with 7 previously reported cases, and the results are as follows: 1) The condition that is most often followed by clavicular osteomyelitis is damage to the periosteum or a hematoma around the periosteum caused by venipuncture. 2) It is suggested that bacteria reach the periosteum by the following four routes: catheter infection, bacteremia, direct seeding from the skin where the catheter is inserted, when insertion actually takes place, and through the catheter after insertion. 3) To prevent this complication, it is important to make sure of the indications for subclavian venipuncture and to precisely determine the optimal method. 4) Surgical treatment should be chosen without delay when antibiotic treatment is unavailable.
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